An external fixator is a surgical unit that allows a fractured or misaligned bone to heal properly.
By immobilizing the bones, the external fixator providesstability to boneand soft tissue.
The equipment is commonly used to help children heal or to protect skin that is damaged around the bone.
Jonathan Cluett, M.D.
This photo contains content that some people may find graphic or disturbing.
Jonathan Cluett, M.D.
Infractures, the pins are typically placed above and below the fracture.
External fixators are often used in severe traumatic injuries.
They allow for rapid stabilization while allowing access to soft tissues that may also need treatment.
This is particularly important when there is significant damage to skin, muscle, nerves, or blood vessels.
After the procedure, you will need to turn the struts daily to help lengthen the bone.
Your child will also have stretching andstrengthening exercisesthey will need to complete daily.
Other Uses
External fixators are also used in other procedures.
Two examples arearthrodesisproceduresand the treatment plan forosteomyelitis.
Arthrodesis is a joint fusion procedure.
External fixation can help stabilize the joint, allowing it to fuse.
Osteomyelitisis a bone infection that can occur due to trauma.
External fixation helps stabilize the bone so that it can heal.
Types of External Fixators
There are several different types of external fixator devices.
The two main types are circular external fixators and monolateral external fixators.
Circular external fixators:Circular external fixatorsgo around the limb being treated.
They have two rings at the top and bottom connected by struts, wires, or pins.
The TSF is more commonly used than the Ilizarov.
Both require adjustments to achieve the desired length of the bone.
The Ilizarove fixator requires a wrench to adjust the unit, and the TSF is more easily adjusted.
However, the Ilizarove is sometimes the preferred design for small children.
Screws are placed in the bone.
The screws are often coated inhydroxyapatiteso that they adhere to the bone better.
These fixators have knobs on them that may need adjusting if the goal is lengthening the bone.
To help prevent infection, following the pin care instructions from your healthcare team is essential.
Your healthcare team will provide you with specific instructions.
Signs of Infection
Some redness and crusting around the pin sites are expected.
You may needantibioticsto clear an infection.
Summary
External fixators allow a healthcare provider to stabilize a broken bone quickly.
They are especially useful in traumas.
They are also beneficial in correcting limb alignment or when a limb needs to be lengthened.
External fixators can serve other uses, too, such as in joint fusions.
Bible JE, Mir HR.External Fixation: Principles and Applications.J Am Acad Orthop Surg.
2015;23(11):683-690. doi:10.5435/JAAOS-D-14-00281
Nemours Children’s Health.Limb lengthening surgery: external fixator.
2019;14(3):148-154.
2023;54(2):422-428.
2018;10(4):e2484.
doi:10.7759/cureus.2484
Hadeed A, Werntz RL, Varacallo M.External Fixation Principles and Overview.
Treasure Island, FL: StatPearls Publishing; 2019.
International Center for Limb Lengthening.External fixators.
Nemours Children’s Health.External fixator: pin care.
De Bastiani G, Apley AG, Goldberg AAJ, eds.Orthofix External Fixation in Trauma and Orthopaedics.
London: Springer; 2000.
